Common Painkillers Increase Heart Risks

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For arthritis patients, taking high doses of painkillers known as NSAIDs (non-steroidal anti-inflammatory drugs) on a daily basis is often the best option to control pain. These common drugs can reduce joint pain and swelling, helping patients to enjoy a reasonable quality of life. But like all drugs, painkillers carry certain risks, and according to an article published last week in The Lancet, NSAIDs may increase risk for heart attack and stroke.

This study analyzed 639 past trials looking at the impact of long-term use of four common types of NSAIDs on cardiovascular risk, including diclofenac, ibuprofen, naproxen and coxib. The goal of this research was to find out how much NSAIDs increase certain health risks—especially among those at increased risk for heart disease—after a year of daily use. So what did they learn?

Not surprisingly, researchers found that high doses of all four drugs increased risk of bleeding—a well-known side effect of painkillers. But researchers were surprised by the significant cardiovascular risk associated with NSAIDs. Three of the drugs—coxib, diclofenac, and ibuprofen—greatly increased cardiovascular risk, particularly in patients with existing risk factors for heart disease. Coxib and diclofenac increased heart attack risk by about one-third, and ibuprofen doubled heart attack risk. Interestingly, the fourth drug analyzed, naproxen, didn’t increase risk for cardiovascular events.

Although the findings sound alarming, experts stress the importance of weighing risks and benefits associated with taking painkillers for an extended period of time. Since NSAIDs have been on the market, we’ve known the possible risks associated with the drug. This study shows that taking high doses of NSAIDs for a prolonged period of time increases the chances that users may experience those risks. It also shows how certain patients, especially those with existing risk factors for heart disease, are at greatest risk for complications. Therefore, it’s important that each patient work with his or her doctor to weigh the possible risks and benefits of taking high doses of painkillers to control chronic pain. For many patients, taking NSAIDs may still be the best option to control pain levels, while others may want to work with their doctor to explore other options.

Questions for You to Consider

What is an NSAID (non-steroidal anti-inflammatory drug)?

NSAIDs are a common type of painkiller used to treat mild to moderate pain or to help relieve symptoms of arthritis. As with all drugs, NSAIDs carry certain risks, and it’s important to check with your doctor before taking NSAIDs, especially for an extended period of time.

Yes, like all drugs, NSAIDs carry risk of complications. The most common complication from taking NSAIDs is increased risk of bleeding and increased cardiovascular risk. Risk for complications typically increases with higher doses and extended use, so it’s important to talk with your doctor before taking NSAIDs, especially high doses for an extended period of time.